Provider Demographics
NPI:1962275354
Name:MARTIN, SAVANNAH MEGAN (PA-C)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MEGAN
Last Name:MARTIN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 ALMAVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5748
Mailing Address - Country:US
Mailing Address - Phone:615-768-8024
Mailing Address - Fax:
Practice Address - Street 1:1923 ALMAVILLE RD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5748
Practice Address - Country:US
Practice Address - Phone:615-768-8024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5747363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant